Netter Atlas of Human Anatomy: Classic Regional Approach - Ebook [8 ed.] 0323680429, 9780323680424

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8

EIGHTH EDITION

FRANK H. NETTER, MD

NET TER ATLAS

HUMAN ANATOMY

of

Classic Regional Approach

ELSEVIER 1600 John F. Kennedy Blvd. Ste. 1600 Philadelphia, PA 19103-­2899 ATLAS OF HUMAN ANATOMY: CLASSIC REGIONAL APPROACH,  EIGHTH EDITION

Standard Edition:       978-­0-­323-­68042-­4 Professional Edition:   978-­0-­323-­79373-­5 International Edition: 978-­0-­323-­79374-­2

Copyright © 2023 by Elsevier Inc. Previous editions copyrighted 2019, 2014, 2011, 2006, 2003, 1997, 1989 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Permission to use Netter Art figures may be sought through the website NetterImages.com or by emailing Elsevier’s Licensing Department at [email protected].

Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. International Standard Book Number: 978-­0-­323-­68042-­4

Publisher: Elyse O’Grady Senior Content Strategist: Marybeth Thiel Publishing Services Manager: Catherine Jackson Senior Project Manager/Specialist: Carrie Stetz Book Design: Renee Duenow

Printed in China 9  8  7  6  5  4  3  2  1

CONSULTING EDITORS Chief Contributing Illustrator and Art Lead Editor

Educational Content Lead Editors

Carlos A.G. Machado, MD

Jennifer K. Brueckner-­Collins, PhD

Terminology Content Lead Editors

Paul E. Neumann, MD

Professor, Department of Medical Neuroscience Faculty of Medicine Dalhousie University Halifax, Nova Scotia Canada

R. Shane Tubbs, MS, PA-­C, PhD

Professor of Neurosurgery, Neurology, Surgery, and Structural and Cellular Biology Director of Surgical Anatomy, Tulane University School of Medicine Program Director of Anatomical Research, Clinical Neuroscience Research Center, Center for Clinical Neurosciences Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana Professor, Department of Neurosurgery, and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana Professor of Anatomy, Department of Anatomical Sciences, St. George’s University, Grenada Honorary Professor, University of Queensland, Brisbane, Australia Faculty, National Skull Base Center of California, Thousand Oakes, California

Electronic Content Lead Editors

Brion Benninger, MD, MBChB, MSc

Professor of Medical Innovation, Technology, & Research Director, Ultrasound Professor of Clinical Anatomy Executive Director, Medical Anatomy Center Department of Medical Anatomical Sciences Faculty, COMP and COMP-Northwest Faculty College of Dentistry, Western University of Health Sciences, Lebanon, Oregon and Pomona, California Faculty, Sports Medicine, Orthopaedic & General Surgery Residencies Samaritan Health Services, Corvallis, Oregon Faculty, Surgery, Orthopedics & Rehabilitation, and Oral Maxillofacial Surgery Oregon Health & Science University, Portland, Oregon Visiting Professor of Medical Innovation and Clinical Anatomy, School of Basic Medicine, Peking Union Medical College, Beijing, China Professor of Medical Innovation and Clinical Anatomy Post Graduate Diploma Surgical Anatomy, Otago University, Dunedin, New Zealand

Todd M. Hoagland, PhD

Clinical Professor of Biomedical Sciences and Occupational Therapy Marquette University College of Health Sciences Milwaukee, Wisconsin

Distinguished Teaching Professor Vice Chair for Educational Programs Department of Anatomical Sciences and Neurobiology University of Louisville School of Medicine Louisville, Kentucky

Martha Johnson Gdowski, PhD

Associate Professor and Associate Chair of Medical Education, Department of Neuroscience University of Rochester School of Medicine and Dentistry Rochester, NY

Virginia T. Lyons, PhD

Associate Professor of Medical Education Associate Dean for Preclinical Education Geisel School of Medicine at Dartmouth Hanover, New Hampshire

Peter J. Ward, PhD

Professor Department of Biomedical Sciences West Virginia School of Osteopathic Medicine Lewisburg, West Virginia

Emeritus Editor

John T. Hansen, PhD

Professor Emeritus of Neuroscience and former Schmitt Chair of Neurobiology and Anatomy and Associate Dean for Admissions University of Rochester Medical Center Rochester, New York

EDITORS OF PREVIOUS EDITIONS First Edition Sharon Colacino, PhD Second Edition Arthur F. Dalley II, PhD Third Edition Carlos A.G. Machado, MD John T. Hansen, PhD Fourth Edition Carlos A.G. Machado, MD John T. Hansen, PhD Jennifer K. Brueckner, PhD Stephen W. Carmichael, PhD, DSc Thomas R. Gest, PhD Noelle A. Granger, PhD Anil H. Waljii, MD, PhD

Fifth Edition Carlos A.G. Machado, MD John T. Hansen, PhD Brion Benninger, MD, MS Jennifer K. Brueckner, PhD Stephen W. Carmichael, PhD, DSc Noelle A. Granger, PhD R. Shane Tubbs, MS, PA-­C, PhD

Seventh Edition Carlos A.G. Machado, MD John T. Hansen, PhD Brion Benninger, MD, MS Jennifer Brueckner-­Collins, PhD Todd M. Hoagland, PhD R. Shane Tubbs, MS, PA-­C, PhD

Sixth Edition Carlos A.G. Machado, MD John T. Hansen, PhD Brion Benninger, MD, MS Jennifer Brueckner-­Collins, PhD Todd M. Hoagland, PhD R. Shane Tubbs, MS, PA-­C, PhD

OTHER CONTRIBUTING ILLUSTRATORS Rob Duckwall, MA (DragonFly Media Group) Kristen Wienandt Marzejon, MS, MFA Tiffany S. DaVanzo, MA, CMI James A. Perkins, MS, MFA

INTERNATIONAL ADVISORY BOARD Nihal Apaydin, MD, PhD

Professor of Anatomy Faculty of Medicine, Department of Anatomy Ankara University; Chief, Department of Multidisciplinary Neuroscience Institute of Health Sciences Ankara, Turkey

Hassan Amiralli, MD, MS, FUICC

Professor and Chair Department of Anatomy American University of Antigua College of Medicine Antigua, West Indies; Former Professor of Surgery Muhimbili University of Health Sciences Daressalaam, Tanzania

Belinda R. Beck, BHMS(Ed), MS, PhD

Professor of Anatomy and Exercise Science Director, Bone Densitometry Research Laboratory Griffith University, Gold Coast Campus Queensland, Australia

Jonathan Campbell, MD, FAAOS

Assistant Professor of Orthopaedic Surgery Division of Sports Medicine Medical College of Wisconsin Milwaukee, Wisconsin

Francisco J. Caycedo, MD, FAAOS St. Vincent’s Hospital Birmingham, Alabama

Thazhumpal Chacko Mathew, MSc, PhD, FRCPath Professor Faculty of Allied Health Sciences Health Sciences Centre Kuwait University Kuwait City, Kuwait

Eduardo Cotecchia Ribeiro, MS, PhD

Associate Professor of Descriptive and Topographic Anatomy School of Medicine Federal University of São Paulo São Paulo, Brazil

William E. Cullinan, PhD

Professor and Dean College for Health Sciences Marquette University Milwaukee, Wisconsin

Elisabeth Eppler, MD University Lecturer Institute of Anatomy University of Berne Berne, Switzerland

Christopher Kelly, MD, MS

North Carolina Heart and Vascular Raleigh, North Carolina

Michelle D. Lazarus, PhD

Director, Centre for Human Anatomy Education Monash Centre for Scholarship in Health Education (MCSHE) Curriculum Integration Network Lead Monash Education Academy Fellow Monash University Clayton, Victoria, Australia

Robert G. Louis, MD, FAANS

Empower360 Endowed Chair for Skull Base and Minimally Invasive Neurosurgery Chair, Division of Neurosurgery Pickup Family Neurosciences Institute Hoag Memorial Hospital Newport Beach, California

Chao Ma, MD

Department of Human Anatomy, Histology & Embryology Peking Union Medical College Beijing, China

Diego Pineda Martínez, MD, PhD

Chief, Department of Innovation in Human Biological Material Professor of Anatomy Faculty of Medicine of the National Autonomous University of Mexico President, Mexican Society of Anatomy Mexico City, Mexico

William J. Swartz, PhD

Emeritus Professor of Cell Biology and Anatomy Louisiana State University Health Sciences Center New Orleans, Louisiana

Kimberly S. Topp, PT, PhD, FAAA

Professor and Chair Emeritus Department of Physical Therapy and Rehabilitation Science School of Medicine University of California San Francisco San Francisco, California

Ivan Varga, PhD

Professor of Anatomy, Histology, and Embryology Faculty of Medicine Comenius University Bratislava, Slovak Republic

Robert J. Ward, MD, CCD, DABR Chief Executive Officer Sullivan’s Island Imaging, LLC Sullivan’s Island, South Carolina; Professor of Radiology Saint Georges University Grenada, West Indies

Alexandra L. Webb, BSc, MChiro, PhD Associate Professor Deputy Director, Medical School College of Health and Medicine Australian National University Canberra, ACT, Australia

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PREFACE The illustrations comprising the Netter Atlas of Human Anatomy were painted by physician-­ artists, Frank H. Netter, MD, and Carlos Machado, MD. Dr. Netter was a surgeon and Dr. Machado is a cardiologist. Their clinical insights and perspectives have informed their approaches to these works of art. The collective expertise of the anatomists, educators, and clinicians guiding the selection, arrangement, labeling, and creation of the illustrations ensures the accuracy, relevancy, and educational power of this outstanding collection. You have a copy of the regionally organized 8th edition with English language terminology. This is the traditional organization and presentation that has been used since the first edition. Also available is a Latin terminology option that is also regionally organized, as well as an option with English terminology organized by body system. In all cases, the same beautiful and instructive Art Plates and Table information are included.

New to this Edition New Art More than 20 new illustrations have been added and over 30 art modifications have been made throughout this edition. Highlights include new views of the temporal and infratemporal fossa, pelvic fascia, nasal cavity and paranasal sinuses, plus multiple new perspectives of the heart, a cross-­section of the foot, enhanced surface anatomy plates, and overviews of many body systems. In these pages you will find the most robust illustrated coverage to date for modern clinical anatomy courses. 

Terminology and Label Updates This 8th edition incorporates terms of the Terminologia Anatomica (2nd edition), as published by the Federative International Programme on Anatomical Terminology in 2019 (https://fipat.library.dal.ca/ta2) and adopted by the International Federation of Associations of Anatomy in 2020. A fully searchable database of the updated Terminologia Anatomica can be accessed at https://ta2viewer.openanatomy.org. Common clinical eponyms and former terminologies are selectively included, parenthetically, for clarity. In addition, a strong effort has been made to reduce label text on the page while maximizing label information through the use of abbreviations (muscle/s = m/mm.; artery/ies = a./aa.; vein/s = v./vv.; and nerve/s = n./nn.) and focusing on the labels most relevant to the subject of each Plate.  Nerve Tables The muscle tables and clinical tables of previous editions have been so positively received that new tables have been added to cover four major nerve groups: cranial nerves and the nerves of the cervical, brachial, and lumbosacral plexuses. 

Future of the Netter Anatomy Atlas As the Netter Atlas continues to evolve to meet the needs of students, educators, and clinicians, we welcome suggestions! Please use the following form to provide your feedback: https://tinyurl.com/NetterAtlas8

To my dear wife, Vera

PREFACE TO THE FIRST EDITION I have often said that my career as a medical artist for almost 50 years has been a sort of “command performance” in the sense that it has grown in response to the desires and requests of the medical profession. Over these many years, I have produced almost 4,000 illustrations, mostly for The CIBA (now Netter) Collection of Medical Illustrations but also for Clinical Symposia. These pictures have been concerned with the varied subdivisions of medical knowledge such as gross anatomy, histology, embryology, physiology, pathology, diagnostic modalities, surgical and therapeutic techniques, and clinical manifestations of a multitude of diseases. As the years went by, however, there were more and more requests from ­ physicians and students for me to produce an atlas purely of gross anatomy. Thus, this atlas has come about, not through any inspiration on my part but rather, like most of my previous works, as a fulfillment of the desires of the medical profession. It involved going back over all the illustrations I had made over so many years, selecting those pertinent to gross anatomy, classifying them and organizing them by system and region, adapting them to page size and space, and arranging them in logical sequence. Anatomy of course does not change, but our understanding of anatomy and its clinical significance does change, as do anatomical terminology and nomenclature. This therefore required much updating of many of the older pictures and

even revision of a number of them in order to make them more pertinent to today’s ever-­expanding scope of medical and surgical practice. In addition, I found that there were gaps in the portrayal of medical knowledge as pictorialized in the illustrations I had previously done, and this necessitated my making a number of new pictures that are included in this volume. In creating an atlas such as this, it is important to achieve a happy medium between complexity and simplification. If the pictures are too complex, they may be difficult and confusing to read; if oversimplified, they may not be adequately definitive or may even be misleading. I have therefore striven for a middle course of realism without the clutter of confusing minutiae. I hope that the students and members of the medical and allied professions will find the illustrations readily understandable, yet instructive and useful. At one point, the publisher and I thought it might be nice to include a foreword by a truly outstanding and renowned anatomist, but there are so many in that category that we could not make a choice. We did think of men like Vesalius, Leonardo da Vinci, William Hunter, and Henry Gray, who of course are unfortunately unavailable, but I do wonder what their comments might have been about this atlas. Frank H. Netter, MD (1906–1991) 

FRANK H. NETTER, MD Frank H. Netter was born in New York City in 1906. He studied art at the Art Students League and the National Academy of Design before entering medical school at New York University, where he received his Doctor of Medicine degree in 1931. During his student years, Dr. Netter’s notebook sketches attracted the attention of the medical faculty and other physicians, allowing him to augment his income by illustrating articles and textbooks. He continued illustrating as a sideline after establishing a surgical practice in 1933, but he ultimately opted to give up his practice in favor of a full-­time commitment to art. After service in the United States Army during World War II, Dr. Netter began his long collaboration with the CIBA Pharmaceutical Company (now Novartis Pharmaceuticals). This 45-­year partnership resulted in the production of the extraordinary collection of medical art so familiar to physicians and other medical professionals worldwide. Icon Learning Systems acquired the Netter Collection in July 2000 and continued to update Dr. Netter’s original paintings and to add newly commissioned paintings by artists trained in the style of Dr. Netter. In 2005, Elsevier Inc. purchased the Netter Collection and all publications from Icon Learning Systems. There are now over



50 publications featuring the art of Dr. Netter available through Elsevier Inc. Dr. Netter’s works are among the finest examples of the use of illustration in the teaching of medical concepts. The 13-­book Netter Collection of Medical Illustrations, which includes the greater part of the more than 20,000 paintings created by Dr. Netter, became and remains one of the most famous medical works ever published. The Netter Atlas of Human Anatomy, first published in 1989, presents the anatomic paintings from the Netter Collection. Now translated into 16 languages, it is the anatomy atlas of choice among medical and health professions students the world over. The Netter illustrations are appreciated not only for their aesthetic qualities, but, more importantly, for their intellectual content. As Dr. Netter wrote in 1949 “clarification of a subject is the aim and goal of illustration. No matter how beautifully painted, how delicately and subtly rendered a subject may be, it is of little value as a medical illustration if it does not serve to make clear some medical point.” Dr. Netter’s planning, conception, point of view, and approach are what inform his paintings and what make them so intellectually valuable. Frank H. Netter, MD, physician and artist, died in 1991.



ABOUT THE EDITORS Carlos A.G. Machado, MD was chosen by Novartis to be Dr. Netter’s successor. He continues to be the main artist who contributes to the Netter collection of medical illustrations. Self-­ taught in medical illustration, cardiologist Carlos Machado has contributed meticulous updates to some of Dr. Netter’s original plates and has created many paintings of his own in the style of Netter as an extension of the Netter collection. Dr. Machado’s photorealistic expertise and his keen insight into the physician/patient relationship inform his vivid and unforgettable visual style. His dedication to researching each topic and subject he paints places him among the premier medical illustrators at work today. Learn more about his background and see more of his art at: https://netterimages.com/artist-­carlos-­a-­g-­machado. html Paul E. Neumann, MD was clinically trained in anatomical pathology and neuropathology. Most of his research publications have been in mouse neurogenetics and molecular human genetics. In the past several years, he has concentrated on the anatomical sciences, and has frequently written about anatomical terminology and anatomical ontology in the journal Clinical Anatomy. As an officer of the Federative International Programme for Anatomical Terminology (FIPAT), he participated in the production of Terminologia Anatomica (2nd edition), Terminologia Embryologica (2nd edition), and Terminologia Neuroanatomica. In addition to serving as the lead Latin editor of the 8th edition of Netter’s Atlas, he was a contributor to the 33rd edition of Dorland’s Illustrated Medical Dictionary. R. Shane Tubbs, MS, PA-­C, PhD is a native of Birmingham, Alabama and a clinical anatomist. His research interests are centered around clinical/surgical problems that are identified and solved with anatomical studies. This investigative paradigm in anatomy as resulted in over 1,700 peer reviewed publications. Dr. Tubbs’ laboratory has made novel discoveries in human anatomy including a new nerve to the skin of the lower eyelid, a new space of the face, a new venous sinus over the spinal cord, new connections between the parts of the sciatic nerve, new ligaments of the neck, a previously undescribed cutaneous branch of the inferior gluteal nerve, and an etiology for postoperative C5 nerve palsies. Moreover, many anatomical feasibility studies from Dr. Tubbs’ laboratory have gone on to be used by surgeons from around the world and have thus resulted in new surgical/clinical procedures such as treating hydrocephalus by shunting cerebrospinal fluid into various bones, restoration of upper limb function in paralyzed patients with neurotization procedures using the contralateral spinal accessory nerve, and harvesting of clavicle for anterior cervical discectomy and fusion procedures in patients with cervical instability or degenerative spine disease.

Dr. Tubbs sits on the editorial board of over 15 anatomical journals and has reviewed for over 150 scientific journals. He has been a visiting professor to major institutions in the United States and worldwide. Dr. Tubbs has authored over 40 books and over 75 book chapters. His published books by Elsevier include Gray’s Anatomy Review, Gray’s Clinical Photographic Dissector of the Human Body, Netter’s Introduction to Clinical Procedures, and Nerves and Nerve Injuries volumes I and II. He is an editor for the 41st and 42nd editions of the over 150-­year-­old Gray’s Anatomy, the 5th through 8th editions of Netter’s Atlas of Anatomy, and is the editor-­in-­chief of the journal Clinical Anatomy. He is the Chair of the Federative International Programme on Anatomical Terminologies (FIPAT). Jennifer K. Brueckner-­Collins, PhD is a proud Kentucky native. She pursued her undergraduate and graduate training at the University of Kentucky. During her second year of graduate school there, she realized that her professional calling was not basic science research in skeletal muscle biology, but was instead helping medical students master the anatomical sciences. She discovered this during a required teaching assistantship in medical histology, where working with students at the 10-­headed microscope changed her career path. The next semester of graduate school, she assisted in teaching dissection-­ based gross anatomy, although she had taken anatomy when the lab component was prosection based. After teaching in the first lab, she knew that she needed to learn anatomy more thoroughly through dissection on her own, so she dissected one to two labs ahead of the students that semester; that was when she really learned anatomy and was inspired to teach this discipline as a profession. All of this occurred in the early 1990s, when pursuing a teaching career was frowned upon by many; it was thought that you only pursued this track if you were unsuccessful in research. She taught anatomy part-­time during the rest of her graduate training, on her own time, to gain requisite experience to ultimately secure a faculty position. Dr. Brueckner-­Collins spent 10 years at the University of Kentucky as a full-­ time faculty member teaching dissection-­based gross anatomy to medical, dental, and allied health students. Then, after meeting the love of her life, she moved to the University of Louisville and has taught medical and dental students there for more than a decade. Over 20 years of teaching full time at two medical schools in the state, her teaching efforts have been recognized through receipt of the highest teaching honor at each medical school in the state, the Provost’s Teaching Award at University of Kentucky, and the Distinguished Teaching Professorship at University of Louisville. Martha Johnson Gdowski, PhD earned her BS in Biology cum laude from Gannon University in 1990, followed by a PhD in Anatomy from the Pennsylvania State University College of Medicine in 1995. She completed postdoctoral

fellowships at the Cleveland Clinic and Northwestern University School of Medicine prior to accepting a faculty position in the Department of Neuroscience at the University of Rochester School of Medicine and Dentistry in 2001. Previous research interests include the development of an adult model of hydrocephalus, sensorimotor integration in the basal ganglia, and sensorimotor integration in normal and pathological aging. Her passion throughout her career has been in her service as an educator. Her teaching has encompassed a variety of learning formats, including didactic lecture, laboratory, journal club, and problem-­ based learning. She has taught for four academic institutions in different capacities (The Pennsylvania State University School of Medicine, Northwestern University School of Medicine, Ithaca College, and The University of Rochester School of Medicine and Dentistry). She has taught in the following curricula: Undergraduate and Graduate Neuroscience, Graduate Neuroanatomy, Graduate Human Anatomy and Physiology for Physical Therapists, Undergraduate Medical Human Anatomy and Histology, and Undergraduate and Graduate Human Anatomy. These experiences have provided an opportunity to instruct students that vary in age, life experience, race, ethnicity, and economic background, revealing how diversity in student populations enriches learning environments in ways that benefit everyone. She has been honored to be the recipient of numerous awards for her teaching and mentoring of students during their undergraduate medical education. Martha enjoys gardening, hiking, and swimming with her husband, Greg Gdowski, PhD, and their dogs, Sophie and Ivy. Virginia T. Lyons, PhD is an Associate Professor of Medical Education and the Associate Dean for Preclinical Education at the Geisel School of Medicine at Dartmouth. She received her BS in Biology from Rochester Institute of Technology and her PhD in Cell Biology and Anatomy from the University of North Carolina at Chapel Hill. Dr. Lyons has devoted her career to education in the anatomical sciences, teaching gross anatomy, histology, embryology, and neuroanatomy to medical students and other health professions students. She has led courses and curricula in human gross anatomy and embryology for more than 20 years and is a strong advocate for incorporating engaged pedagogies into preclinical medical education. Dr. Lyons has been recognized with numerous awards for teaching and mentoring students and was elected to the Dartmouth chapter of the Alpha Omega Alpha Honor Medical Society. She is the author of Netter’s Essential Systems-­ Based Anatomy and co-­ author of the Human Anatomy Learning Modules website accessed by students worldwide. Dr. Lyons also serves as the Discipline Editor for Anatomy on the Aquifer Sciences Curriculum Editorial Board, working to integrate anatomical concepts into virtual patient cases that are used in multiple settings including clerkships and residency training. Peter J. Ward, PhD grew up in Casper, Wyoming, grad­ uating from Kelly Walsh High School and then attending Carnegie Mellon University in Pittsburgh, Pennsylvania.

He began graduate school at Purdue University, where he first encountered gross anatomy, histology, embryology, and neuroanatomy. Having found a course of study that engrossed him, he helped teach those courses in the veterinary and medical programs at Purdue. Dr. Ward completed a PhD program in anatomy education and, in 2005, he joined the faculty at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, West Virginia. There he has taught gross anatomy, embryology, neuroscience, histology, and the history of medicine. Dr. Ward has received numerous teaching awards, including the WVSOM Golden Key Award, the Basmajian Award from the American Association of Anatomists, and has been a two-­ time finalist in the West Virginia Merit Foundation’s Professor of the Year selection. Dr. Ward has also been director of the WVSOM plastination facility, coordinator of the anatomy graduate teaching assistants, chair of the curriculum committee, chair of the faculty council, creator and director of a clinical anatomy elective course, and host of many anatomy-­ centered events between WVSOM and two Japanese Colleges of Osteopathy. Dr. Ward has also served as council member and association secretary for the American Association of Clinical Anatomists. In conjunction with Bone Clones, Inc., Dr. Ward has produced tactile models that mimic the feel of anatomical structures when intact and when ruptured during the physical examination. He created the YouTube channel Clinical Anatomy Explained! and continues to pursue interesting ways to present the anatomical sciences to the public. Dr. Ward was the Senior Associate Editor for the three volumes of The Netter Collection: The Digestive System, 2nd Edition, a contributor to Gray’s Anatomy, 42nd Edition, and is author of Netter’s Integrated Musculoskeletal System: Clinical Anatomy Explained. Brion Benninger, MD, MBChB, MSc currently teaches surgical, imaging, and dynamic anatomy to medical students and residents in several countries (United States, New Zealand, China, Japan, Korea, Taiwan, The Caribbean, Mexico). He develops, invents, and assesses ultrasound probes, medical equipment, simulations, and software while identifying dynamic anatomy. He enjoys mixing educational techniques integrating macro imaging and surgical anatomy. Dr. Benninger developed the teaching theory of anatomy deconstruction/reconstruction and was the first to combine ultrasound with Google Glass during physical examination, coining the term “triple feedback examination.” An early user of ultrasound, he continues to develop eFAST teaching and training techniques, has developed and shares a patent on a novel ultrasound finger probe, and is currently developing a new revolutionary ultrasound probe for breast screening. He is a reviewer for several ultrasound, clinical anatomy, surgical, and radiology journals and edits and writes medical textbooks. His research interests integrate clinical anatomy with conventional and emerging technologies to improve training techniques in situ and simulation. Dr. Benninger pioneered and coined the term “dynamic anatomy,”

developed a technique to deliver novel contrast medium to humans, and was the first to reveal vessels and nerves not previously seen using CT and MRI imaging. He has mentored more than 200 students on over 350 research projects presented at national and international conferences and has received numerous awards for projects related to emergency procedures, ultrasound, sports medicine, clinical anatomy, medical simulation, reverse translational research, medical education, and technology. He is proud to have received medical teaching awards from several countries and institutions, including being the first recipient in more than 25 years to receive the Commendation Medal Award from the Commission of Osteopathic Accreditation for innovative clinical anatomy teaching that he designed and facilitated in Lebanon, Oregon. Dr. Benninger has received sports medicine accolades from Sir Roger Bannister regarding his medical invention on shoulder proprioception. He is also Executive Director of the Medical Anatomy Center and collaborates with colleagues globally from surgical and nonsurgical specialties. He is also an invited course speaker for surgical anatomy in New Zealand. Dr. Benninger collects medical history books, loves mountains and sports, and is an anonymous restaurant critic. British mentors directly responsible for his training include Prof. Peter Bell (surgery), Prof. Sir Alec Jeffreys (genetic fingerprinting), Profs. David deBono and Tony Gershlick (cardiology), Prof. Roger Greenhalgh (vascular surgery), Profs. Chris Colton, John Webb, and Angus Wallace (orthopaedics), Prof. Harold Ellis CBE (surgery and clinical anatomy), and Prof. Susan Standring (Guys Hospital/Kings College). Todd M. Hoagland, PhD is Clinical Professor of Biomedical Sciences and Occupational Therapy at Marquette University in the College of Health Sciences. Previously he was Professor of Anatomy at the Medical College of Wisconsin (MCW). Prior to MCW, Dr. Hoagland was at

Boston University School of Medicine (BUSM) and he still holds an adjunct faculty position at Boston University Goldman School of Dental Medicine. Dr. Hoagland is a passionate teacher and is dedicated to helping students achieve their goals. He believes in being a strong steward of the anatomical sciences, which involves teaching it to students while contemporaneously developing resources to improve the transfer of knowledge and preparing the next generation to be even better teachers. While at BUSM, Dr. Hoagland was a leader for the Carnegie Initiative on the Doctorate in Neuroscience and helped develop the Vesalius Program (teacher training) for graduate students. The program ensures that graduate students learn about effective teaching, receive authentic experiences in the classroom, and understand how to share what they learn via scholarship. Dr. Hoagland’s dedication to health professions education has been richly rewarded by numerous teaching awards from the University of Notre Dame, BUSM, and MCW. Dr. Hoagland received the Award for Outstanding Ethical Leadership in 2009, was inducted into the Alpha Omega Alpha Honor Medical Society in 2010, received the American Association of Anatomists Basmajian Award in 2012, and was inducted into the Society of Teaching Scholars in 2012 and was their director from 2016–2020. Dr. Hoagland’s scholarly activity centers on (1) evaluating content and instructional/learning methodology in Clinical Human Anatomy and Neuroanatomy courses, especially as relevant to clinical practice, (2) translating basic anatomical science research findings into clinically meaningful information, and (3) evaluating professionalism in students to enhance their self-­awareness and improve patient care outcomes. Dr. Hoagland is also consulting editor for Netter’s Atlas of Human Anatomy, co-­author for the digital anatomy textbook AnatomyOne, and lead author for Clinical Human Anatomy Dissection Guide.

ACKNOWLEDGMENTS Carlos A. G. Machado, MD

With the completion of this 8th edition, I celebrate 27 years contributing to the Netter brand of educational products, 25 years of which have been dedicated to the update—seven editions—of this highly prestigious, from birth, Atlas of Human Anatomy. For these 25 years I have had the privilege and honor of working with some of the most knowledgeable anatomists, educators, and consulting editors—my treasured friends—from whom I have learned considerably. For the last 16 years it has also been a great privilege to be part of the Elsevier team and be under the skillful coordination and orientation of Marybeth Thiel, Elsevier’s Senior Content Development Specialist, and Elyse O’Grady, Executive Content Strategist. I thank both for their friendship, support, sensibility, and very dedicated work. Once more I thank my wife Adriana and my daughter Beatriz for all their love and encouragement, and for patiently steering me back on track when I get lost in philosophical divagations about turning scientific research into artistic inspiration—and vice-­versa! It is impossible to put in words how thankful I am to my much-­loved parents, Carlos and Neide, for their importance in my education and in the formation of my moral and ethical values. I am eternally grateful to the body donors for their inestimable contribution to the correct understanding of human anatomy; to the students, teachers, health professionals, colleagues, educational institutions, and friends who have, anonymously or not, directly or indirectly, been an enormous source of motivation and invaluable scientific references, constructive comments, and relevant suggestions. My last thanks, but far from being the least, go to my teachers Eugênio Cavalcante, Mário Fortes, and Paulo Carneiro, for their inspiring teachings on the practical application of the knowledge of anatomy. 

My work with the Netter Atlas and the people associated with it over the past 15 years has played an instrumental role in helping me develop and sustain these three metaphorical bones in my professional and personal life. I am forever grateful to John Hansen, who believed in my ability to serve as an editor starting with the 4th edition. I extend my sincere thanks to Marybeth Thiel and Elyse O’Grady for not only being the finest of colleagues, but part of my professional family as well. Thanks to you both for your professionalism, support, patience, and collegiality. To Carlos Machado, you continue to amaze me and inspire me with your special gift of bringing anatomy to life through your art. For this edition, I also count in my blessings, the ability to work closely with the talented team of educational leaders, including Martha Gdowski, Virginia Lyons, and Peter Ward. It is humbling to work with such brilliant and dedicated teachers as we collectively assembled the systems-­based Netter Atlas concept. Finally, I dedicate my work on this edition with unconditional and infinite love to Kurt, Lincoln, my Dad in Heaven, as well as my dog boys, Bingo and Biscuit. 

Martha Johnson Gdowski, PhD

I am grateful for the honor to work with the team of editors that Elsevier has selected for the preparation of this 8th edition; they are exceptional in their knowledge, passion as educators, and collegiality. I especially would like to thank Elyse O’Grady and Marybeth Thiel, who have been outstanding in their expertise, patience, and guidance. I am grateful to John T. Hansen, PhD, for his guidance, mentorship, and friendship as a colleague at the University of Rochester and for giving me the opportunity to participate in this work. He continues to be an outstanding role model who has shaped my career as an anatomical sciences educator. Special thanks to Carlos Machado for his gift for making challenging anatomical dissections and difficult concepts accessible to students Paul E. Neumann, MD of anatomy through his artistry, research of the details, It has been a privilege to work on the English and Latin and thoughtful discussions. I am indebted to the selfless editions of Netter’s Atlas of Human Anatomy. I thank individuals who have gifted their bodies for anatomical the staff at Elsevier (especially Elyse O’Grady, Marybeth study, the students of anatomy, and my colleagues at the Thiel and Carrie Stetz), Dr. Carlos Machado, and the University of Rochester, all of whom motivate me to work other editors for their efforts to produce a new, improved to be the best educator I can be. I am most grateful for my edition. I am also grateful to my wife, Sandra Powell, and loving husband and best friend, Greg, who is my greatest my daughter, Eve, for their support of my academic work.  source of support and inspiration. 

R. Shane Tubbs, MS, PA-­C, PhD

I thank Elyse O’Grady and Marybeth Thiel for their dedication and hard work on this edition. As always, I thank my wife, Susan, and son, Isaiah, for their patience with me on such projects. Additionally, I thank Drs. George and Frank Salter who inspired and encouraged me along my path to anatomy. 

Jennifer K. Brueckner-­Collins, PhD

Reba McEntire once said “To succeed in life, you need three things: a wishbone, a backbone and a funny bone.”

Virginia T. Lyons, PhD

It has been a joy to work with members of the editorial team on the iconic Atlas of Human Anatomy by Frank Netter. I would like to thank Elyse O’Grady and Marybeth Thiel for their expert guidance and ability to nourish the creative process while also keeping us focused (otherwise we would have reveled in debating anatomy minutiae for hours!). I am amazed by the talent of Carlos Machado, who is able to transform our ideas into beautiful, detailed illustrations that simplify concepts for students. I appreciate the patience and support of my husband, Patrick, and my

children, Sean and Nora, who keep me sane when things get busy. Finally, I am grateful for the opportunity to teach and learn from the outstanding medical students at the Geisel School of Medicine at Dartmouth. I am fulfilled by their energy, curiosity, and love of learning. 

Peter J. Ward, PhD

It is a thrill and honor to contribute to the 8th edition of Netter’s Atlas of Human Anatomy. It still amazes me that I am helping to showcase the incomparable illustrations of Frank Netter and Carlos Machado. I hope that this atlas continues to bring these works of medical art to a new generation of students as they begin investigating the awesome enigma of the human body. Thanks to all the amazing contributors and to the hardworking team at Elsevier, especially Marybeth Thiel and Elyse O’Grady, for keeping all of us moving forward. Thank you especially to Todd Hoagland for recommending me to the team. I have immense gratitude to James Walker and Kevin Hannon, who introduced me to the world of anatomy. They both seamlessly combined high expectations for their students along with enthusiastic teaching that made the topic fascinating and rewarding. Great thanks to my parents, Robert and Lucinda Ward, for their lifelong support of my education and for the many formative museum trips to stare at dinosaur bones. Sarah, Archer, and Dashiell, you are all the reason I work hard and try to make the world a slightly better place. Your love and enthusiasm mean everything to me. 

Brion Benninger, MD, MBChB, MSc

I thank all the healthcare institutions worldwide and the allopathic and osteopathic associations who have provided me the privilege to wake up each day and focus on how to improve our knowledge of teaching and healing the anatomy of the mind, body, and soul while nurturing humanism. I am grateful and fortunate to have my lovely wife, Alison, and thoughtful son, Jack, support my efforts during late nights and long weekends. Their laughs and experiences complete my life. I thank Elsevier, especially Marybeth Thiel, Elyse O’Grady, and Madelene Hyde for expecting the highest standards and providing guidance, enabling my fellow coeditors to work in a fluid diverse environment. Many thanks to Carlos Machado and Frank Netter: the world is proud. I thank clinicians who trained

me, especially my early gifted surgeon/anatomist/teacher mentors, Drs. Gerald Tressidor and Harold Ellis CBE (Cambridge & Guy’s Hospital); Dr. S. Standring and Dr. M. England, who embody professionalism; Drs. P. Crone, E. Szeto, and J. Heatherington, for supporting innovative medical education; my past, current, and future students and patients; and clinical colleagues from all corners of the world who keep medicine and anatomy dynamic, fresh, and wanting. Special thanks to Drs. J.L. Horn, S. Echols, J. Anderson, and J. Underwood, friends, mentors and fellow visionaries who also see “outside the box,” challenging the status quo. Heartfelt tribute to my late mentors, friends, and sister, Jim McDaniel, Bill Bryan, and Gail Hendricks, who represent what is good in teaching, caring, and healing. They made this world a wee bit better. Lastly, I thank my mother for her love of education and equality and my father for his inquisitive and creative mind. 

Todd M. Hoagland, PhD

It is a privilege to teach clinical human anatomy, and I am eternally grateful to all the body donors and their families for enabling healthcare professionals to train in the dissection laboratory. It is my honor to work with occupational therapy and health professions students and colleagues at Marquette University. I am grateful to John Hansen and the professionals of the Elsevier team for the opportunity to be a steward of the incomparable Netter Atlas. Marybeth Thiel and Elyse O’Grady were especially helpful and a pleasure to work with. It was an honor to collaborate with the brilliant Carlos Machado and all the consulting editors. I thank Dave Bolender, Brian Bear, and Rebecca Lufler for being outstanding colleagues, and I thank all the graduate students I’ve worked with for helping me grow as a person; it is such a pleasure to see them flourish. I am deeply appreciative of Stan Hillman and Jack O’Malley for inspiring me with masterful teaching and rigorous expectations. I am indebted to Gary Kolesari and Richard Hoyt Jr for helping me become a competent clinical anatomist, and to Rob Bouchie for the intangibles and his camaraderie. I am most grateful to my brother, Bill, for his unwavering optimism and for always being there. I thank my mother, Liz, for her dedication and love, and for instilling a strong work ethic. I am humbled by my three awesome children, Ella, Caleb, and Gregory, for helping me redefine love, wonder, and joy. Olya, ty moye solntse!

CONTENTS 7th Edition to 8th Edition Plate Number Conversion Chart Available Online at https://tinyurl.com/Netter7to8conversion

SECTION 1

INTRODUCTION  •  Plates 1–21

General Anatomy  •  Plates 1–­3

1 Body Planes and Terms of Relationship 2 Body Parts: Anterior View of Female 3 Body Parts: Posterior View of Male

Systematic Anatomy  •  Plates 4–­21

4 Overview of Nervous System 5 Dermatomes of Upper and Lower Limbs 6 Sympathetic Nervous System: Schema 7 Parasympathetic Nervous System: Schema 8 Overview of Skeletal System 9 Types of Synovial Joints 10 Overview of Muscular System 11 Segmental Motor Nerve Function 12 Cross Section of Skin 13 Overview of Cardiovascular System 14 Major Arteries and Pulse Points 15 Major Systemic Veins of Cardiovascular System 16 Overview of Lymph Vessels and Lymphoid Organs 17 Overview of Respiratory System 18 Overview of Digestive System 19 Overview of Urinary System 20 Overview of Reproductive System 21 Overview of Endocrine System

Electronic Bonus Plates  •  Plates BP 1–­BP 13

BP 1 BP 2 BP 3 BP 4 BP 5 BP 6 BP 7 BP 8 BP 9 BP 10 BP 11 BP 12 BP 13

Pilosebaceous Apparatus Major Body Cavities Neurons and Synapses Features of a Typical Peripheral Nerve Sites of Visceral Referred Pain Sympathetic Nervous System: General Topography Parasympathetic Nervous System: General Topography Cholinergic and Adrenergic Synapses: Schema Architecture of Bone Muscle Structure Joints: Connective Tissues and Articular Cartilage Cardiovascular System: Composition of Blood Arterial Wall

SECTION 2

HEAD AND NECK  •  Plates 22–­177

Surface Anatomy  •  Plates 22–24

22 Surface Anatomy of Head and Neck 23 Cutaneous Nerves of Head and Neck 24 Superficial Arteries and Veins of Face and Scalp

Bones and Joints  •  Plates 25–47

25 Skull: Anterior View 26 Skull: Radiographs 27 Skull: Lateral View 28 Skull: Lateral Radiograph 29 Cranium: Median Section 30 Calvaria 31 Cranial Base: Inferior View 32 Cranial Base: Superior View 33 Foramina and Canals of Cranial Base: Inferior View 34 Foramina and Canals of Cranial Base: Superior View 35 Cranium of Newborn 36 Bony Framework of Head and Neck 37 Nasal Skeleton and Paranasal Sinuses 38 Cranium: Posterior and Lateral Views 39 Mandible 40 Teeth 41 Tooth 42 Temporomandibular Joint 43 Cervical Vertebrae: Atlas and Axis 44 Cervical Vertebrae 45 Cervical Part of Spinal Column 46 External Craniocervical Ligaments 47 Internal Craniocervical Ligaments

Neck  •  Plates 48–58





48 Muscles of Facial Expression: Lateral View 49 Muscles of Neck: Anterior View 50 Superficial Veins of Neck 51 Fascial Layers of Neck 52 Cervical Fasciae 53 Infrahyoid and Suprahyoid Muscles 54 Muscles of Neck: Lateral View 55 Anterior and Lateral Cervical Muscles 56 Nerves of Neck 57 Nerves of Neck and Cervical Plexus 58 Carotid Arteries

Nose  •  Plates 59–82

59 Skeleton of Nose 60 Muscles, Nerves, and Arteries of Face 61 Lateral Wall of Nasal Cavity 62 Lateral Wall of Nasal Cavity of Cranium 63 Medial Wall of Nasal Cavity (Nasal Septum) 64 Nerves of Nasal Cavity 65 Vasculature of Nasal Cavity 66 Nerves of Nasal Cavity: Bony Nasal Septum Turned Up 67 Paranasal Sinuses: Paramedian Views 68 Paranasal Sinuses: Changes with Age 69 Paranasal Sinuses: Coronal and Transverse Sections 70 Salivary Glands 71 Facial Nerve Branches and Parotid Gland 72 Muscles of Mastication: Masseter and Temporalis Muscle 73 Muscles of Mastication: Pterygoid Muscles 74 Maxillary Artery 75 Temporal and Infratemporal Fossae 76 Superficial Temporal and Maxillary Arteries 77 Mandibular Nerve (CN V3) 78 Infratemporal Fossa 79 Ophthalmic and Maxillary Nerves 80 Autonomic Innervation of Nasal Cavity 81 Nerves and Arteries of Midface 82 Orientation of Nerves and Vessels of Cranial Base

Mouth  •  Plates 83–90

83 Inspection of Oral Cavity 84 Afferent Innervation of Oral Cavity and Tongue 85 Roof of Oral Cavity 86 Tongue and Salivary Glands: Sections 87 Suprahyoid Muscles 88 Tongue 89 Dorsum of Tongue 90 Fauces

Pharynx  •  Plates 91–102

91 Posterior View of Pharynx: Nerves and Vessels 92 Muscles of Pharynx: Partially Opened Posterior View 93 Pharynx: Opened Posterior View 94 Pharyngoesophageal Junction 95 Pharynx: Medial View 96 Muscles of Pharynx: Medial View 97 Muscles of Pharynx: Lateral View



98 Nerves of Oral and Pharyngeal Regions 99 Arteries of Head and Neck 100 Veins of Head and Neck 101 Lymph Nodes of Head and Neck 102 Lymph Nodes of Pharynx and Tongue

Larynx and Endocrine Glands  •  Plates 103–109

103 Thyroid Gland: Anterior View 104 Thyroid Gland: Posterior View 105 Thyroid and Parathyroid Glands 106 Cartilages of Larynx 107 Intrinsic Muscles of Larynx 108 Nerves and Coronal Section of Larynx 109 Action of Intrinsic Muscles of Larynx

Eye  •  Plates 110–120

110 Eyelids 111 Lacrimal Apparatus 112 Extrinsic Eye Muscles 113 Nerves of Orbit 114 Superior and Anterior Views of Orbit 115 Arteries and Veins of Orbit and Eyelids 116 Eyeball: Transverse Section 117 Anterior and Posterior Chambers of Eyeball 118 Lens and Supporting Structures 119 Intrinsic Arteries and Veins of Eye 120 Vascular Supply of Eye

Ear  •  Plates 121–126

121 Ear and Course of Sound in Cochlea 122 External Ear and Tympanic Cavity 123 Tympanic Cavity 124 Bony and Membranous Labyrinths 125 Bony and Membranous Labyrinths: Schema and Section 126 Orientation of Labyrinths in Cranium

Brain and Meninges  •  Plates 127–142

127 Meninges and Diploic Veins 128 Meningeal Arteries 129 Meninges and Superficial Cerebral Veins 130 Dural Venous Sinuses: Sagittal Section 131 Dural Venous Sinuses: Cranial Base 132 Brain: Lateral Views 133 Brain: Medial Views 134 Brain: Inferior View 135 Ventricles of Brain



136 Circulation of Cerebrospinal Fluid 137 Basal Nuclei 138 Thalamus and Related Structures 139 Hippocampus and Fornix 140 Brain Stem 141 Ventricles and Cerebellum 142 Cerebellum

Cranial and Cervical Nerves  •  Plates 143–162

143 Cranial Nerve Nuclei in Brain Stem: Schema (Posterior View) 144 Cranial Nerve Nuclei in Brain Stem: Schema (Medial View) 145 Cranial Nerves: Schema of Motor and Sensory Distribution 146 Olfactory Nerve (CN I) and Olfactory Pathways: Schema 147 Optic Nerve (CN II) and Visual Pathway: Schema 148 Oculomotor (CN III), Trochlear (CN IV), and Abducens (CN VI) Nerves: Schema 149 Trigeminal Nerve (CN V): Schema 150 Facial Nerve (CN VII): Schema 151 Vestibulocochlear Nerve (CN VIII): Schema 152 Glossopharyngeal Nerve (CN IX): Schema 153 Vagus Nerve (CN X): Schema 154 Accessory Nerve (CN XI): Schema 155 Hypoglossal Nerve (CN XII): Schema 156 Cervical Plexus: Schema 157 Autonomic Nerves in Neck 158 Autonomic Nerves in Head 159 Ciliary Ganglion: Schema 160 Pterygopalatine and Submandibular Ganglia: Schema 161 Otic Ganglion: Schema 162 Taste Pathways: Schema

Cerebral Vasculature  •  Plates 163–175

163 Arteries to Brain and Meninges 164 Internal Carotid Artery in Petrous Part of Temporal Bone 165 Arteries to Brain: Schema 166 Arteries of Brain: Inferior Views 167 Cerebral Arterial Circle (of Willis) 168 Arteries of Brain: Frontal View and Section 169 Arteries of Brain: Lateral and Medial Views 170 Arteries of Brain: Branches of Vertebral and Basilar Arteries 171 Veins of Posterior Cranial Fossa 172 Deep Veins of Brain 173 Subependymal Veins of Brain 174 Hypothalamus and Hypophysis 175 Vasculature of Hypothalamus and Hypophysis

Regional Imaging  •  Plates 176–177

176 Cranial Imaging (MRA and MRV) 177 Cranial Imaging (MRI)

Structures with High Clinical Significance  •  Tables 2.1–2.4 Cranial Nerves  •  Tables 2.5–2.8 Branches of Cervical Plexus  •  Table 2.9 Muscles  •  Tables 2.10–2.14 Electronic Bonus Plates  •  Plates BP 14–BP 32

SECTION 3

BP 14 BP 15 BP 16 BP 17 BP 18 BP 19 BP 20 BP 21 BP 22 BP 23 BP 24 BP 25 BP 26 BP 27 BP 28 BP 29 BP 30 BP 31 BP 32

Somatosensory System: Trunk and Limbs Pyramidal System 3D Skull Reconstruction CTs Degenerative Changes in Cervical Vertebrae Atlantooccipital Junction Muscles of Facial Expression: Anterior View Musculature of Face Arteries of Nasal Cavity: Bony Nasal Septum Turned Up Nose and Maxillary Sinus: Transverse Section Paranasal Sinuses Subclavian Artery Opening of Mandible Afferent Innervation of Oral Cavity and Pharynx Fasciae of Orbit and Eyeball Tympanic Cavity: Medial and Lateral Views Anatomy of Pediatric Ear Auditory Tube (Eustachian) Cranial Imaging (MRV and MRA) Axial and Coronal MRIs of Brain

BACK  •  Plates 178–201

Surface Anatomy  •  Plate 178 178  Surface Anatomy of Back



Vertebral Column  •  Plates 179–185

179 Vertebral Column 180 Thoracic Vertebrae 181 Lumbar Vertebrae 182 Vertebrae: Radiograph and MRI 183 Sacrum and Coccyx 184 Ligaments of Vertebral Column: Lumbosacral Region 185 Joints of Vertebral Column: Lumbar Region

Spinal Cord  •  Plates 186–194

186 Spinal Cord and Spinal Nerves 187 Spinal Nerve Roots and Vertebrae 188 Dermatomes 189 Spinal Meninges and Nerve Roots 190 Spinal Nerve, Roots, and Rami 191 Arteries of Spinal Cord: Schema 192 Arteries of Spinal Cord: Intrinsic Distribution 193 Veins of Spinal Cord and Vertebral Column 194 Veins of Vertebral Column: Vertebral Veins

Muscles and Nerves  •  Plates 195–­199

195 Muscles of Back: Superficial Layer 196 Muscles of Back: Intermediate Layer 197 Muscles of Back: Deep Layer 198 Nerves of Back 199 Nerves of Back of Neck

Cross-­Sectional Anatomy  •  Plates 200–­201

200 Lumbar Region of Back: Cross Section 201 Typical Thoracic Spinal Nerve

Structures with High Clinical Significance  •  Table 3.1 Muscles  •  Tables 3.2–3.4 Electronic Bonus Plates  •  Plates BP 33–BP 40

SECTION 4

BP 33 BP 34 BP 35 BP 36 BP 37 BP 38 BP 39 BP 40

Ligaments of Vertebral Column Cervical Spine: Radiographs Cervical Spine: MRI and Radiograph Thoracolumbar Spine: Lateral Radiograph Lumbar Vertebrae: Radiographs Lumbar Spine: MRIs Vertebral Veins: Detail Showing Venous Communications Spinal Cord Cross Sections: Fiber Tracts

THORAX  •  Plates 202–266

Surface Anatomy  •  Plate 202

202 Surface Anatomy of Thorax

Thoracic Skeleton  •  Plates 203–­204

203 Bony Framework of Thorax 204 Ribs and Associated Joints

Mammary Glands  •  Plates 205–­208

205 Mammary Glands 206 Arteries of Breast 207 Lymph Vessels and Lymph Nodes of Breast 208 Lymphatic Drainage of Breast

Thoracic Wall and Diaphragm  •  Plates 209–­216

209 Anterior Thoracic Wall: Superficial Dissection 210 Anterior Thoracic Wall: Deeper Dissection 211 Anterior Thoracic Wall: Internal View 212 Intercostal Nerves and Arteries 213 Veins of Thoracic Wall 214 Phrenic Nerve and Relationship to Pericardium 215 Diaphragm: Thoracic Surface 216 Diaphragm: Abdominal Surface

Lungs, Trachea and Bronchi  •  Plates 217–­230

217 Lungs in Thorax: Anterior View 218 Lungs in Thorax: Posterior View 219 Lungs in Situ: Anterior View 220 Great Vessels of Mediastinum 221 Lungs: Medial Views 222 Bronchial Arteries and Veins 223 Bronchopulmonary Segments: Anterior and Posterior Views 224 Bronchopulmonary Segments: Medial and Lateral Views 225 Trachea and Major Bronchi 226 Bronchi and Intrapulmonary Airways 227 Intrapulmonary Blood Circulation: Schema 228 Lymph Vessels of Thorax and Pulmonary and Mediastinal Lymph Nodes 229 Autonomic Nerves of Thorax 230 Innervation of Tracheobronchial Tree: Schema

Heart  •  Plates 231–­250

231 Heart in Situ 232 Heart: Anterior Exposure 233 Heart and Precordial Areas of Auscultation 234 Heart: Radiographs and CT Angiogram 235 Heart: Base and Diaphragmatic Surface 236 Pericardial Sac and Pericardial Cavity 237 Mediastinum: Cross Section 238 Thorax: Coronal Section of Heart and Ascending Aorta 239 Coronary Arteries and Cardiac Veins 240 Coronary Arteries: Imaging 241 Right Atrium and Ventricle 242 Left Atrium and Ventricle



243 Valvular Complex of Heart 244 Valvular Complex of Heart (Continued) 245 Atria, Ventricles, and Interventricular Septum 246 Heart Valves 247 Prenatal and Postnatal Circulation 248 Conducting System of Heart 249 Nerves of Thorax 250 Innervation of Heart: Schema

Mediastinum  •  Plates 251–­261

251 Mediastinum: Right Lateral View 252 Mediastinum: Left Lateral View 253 Phrenic Nerve 254 Esophagus in Situ 255 Esophagus: Constrictions and Relations 256 Musculature of Esophagus 257 Esophagogastric Junction 258 Arteries of Esophagus 259 Veins of Esophagus 260 Lymph Vessels and Lymph Nodes of Esophagus 261 Nerves of Esophagus

Cross-­Sectional Anatomy  •  Plates 262–­266

262 Thorax: Axial CT Images 263 Cross Section of Thorax at T3 Vertebral Level 264 Cross Section of Thorax at T3/T4 Disc Level 265 Cross Section of Thorax at T4/T5 Disc Level 266 Cross Section of Thorax at T7 Vertebral Level

Structures with High Clinical Significance  •  Tables 4.1–4.3 Muscles  •  Table 4.4 Electronic Bonus Plates  •  Plates BP 41–BP 52

BP 41 Cervical Ribs and Related Variations BP 42 Muscle Attachments of Ribs BP 43 Muscles of Respiration BP 44 Intrapulmonary Airways: Schema BP 45 Anatomy of Ventilation and Respiration BP 46 Coronary Arteries: Right Anterolateral Views with Arteriograms BP 47 Coronary Arteries and Cardiac Veins: Variations BP 48 Intrinsic Nerves and Variations in Nerves of Esophagus BP 49 Arteries of Esophagus: Variations BP 50 Thorax: Coronal Section BP 51 Thorax: Coronal CTs BP 52 Innervation of Blood Vessels: Schema

SECTION 5

ABDOMEN  •  Plates 267–351

Surface Anatomy  •  Plate 267

267 Surface Anatomy of Abdomen

Abdominal Wall  •  Plates 268–­287

268 Bony Framework of Abdomen 269 Regions and Planes of Abdomen 270 Anterior Abdominal Wall: Superficial Dissection 271 Anterior Abdominal Wall: Intermediate Dissection 272 Anterior Abdominal Wall: Deep Dissection 273 Rectus Sheath: Cross Section 274 Anterior Abdominal Wall: Internal View 275 Posterolateral Abdominal Wall 276 Arteries of Anterior Abdominal Wall 277 Veins of Anterior Abdominal Wall 278 Nerves of Anterior Abdominal Wall 279 Intercostal Nerves 280 Inguinal Region: Dissections 281 Inguinal Canal and Spermatic Cord 282 Femoral Sheath and Inguinal Canal 283 Posterior Abdominal Wall: Internal View 284 Arteries of Posterior Abdominal Wall 285 Veins of Posterior Abdominal Wall 286 Lymph Vessels and Lymph Nodes of Posterior Abdominal Wall 287 Nerves of Posterior Abdominal Wall

Peritoneal Cavity  •  Plates 288–­293

288 Greater Omentum and Abdominal Viscera 289 Mesenteries and Suspensory Muscle of Duodenum 290 Mesocolons and Root of Mesentery 291 Omental Bursa: Stomach Reflected 292 Omental Bursa: Cross Section 293 Peritoneum of Posterior Abdominal Wall

Stomach and Intestines  •  Plates 294–­301

294 Stomach in Situ 295 Mucosa of Stomach 296 Duodenum in Situ 297 Mucosa and Musculature of Small Intestine 298 Ileocecal Junction 299 Cecum and Ileal Orifice 300 Vermiform Appendix 301 Mucosa and Musculature of Large Intestine

Liver, Gallbladder, Pancreas and Spleen  •  Plates 302–­307

302 Surfaces and Bed of Liver 303 Liver in Situ: Vascular and Duct Systems 304 Liver Structure: Schema 305 Gallbladder, Extrahepatic Bile Ducts, and Pancreatic Duct 306 Pancreas in Situ 307 Spleen

Visceral Vasculature  •  Plates 308–­318

308 Arteries of Stomach, Liver, and Spleen 309 Celiac Trunk and Branches 310 Arteries of Liver, Pancreas, Duodenum, and Spleen 311 Celiac Arteriogram and CT Angiogram 312 Arteries of Duodenum and Head of Pancreas 313 Arteries of Small Intestine 314 Arteries of Large Intestine 315 Veins of Stomach, Duodenum, Pancreas, and Spleen 316 Veins of Small Intestine 317 Veins of Large Intestine 318 Hepatic Portal Vein, Tributaries, and Portacaval Anastomoses

Visceral Nerves and Plexuses  •  Plates 319–­329

319 Autonomic Nerves and Ganglia of Abdomen 320 Autonomic Innervation of Stomach and Duodenum 321 Autonomic Innervation of Stomach and Duodenum (Continued) 322 Autonomic Innervation of Small Intestine 323 Autonomic Innervation of Large Intestine 324 Autonomic Innervation of Intestine: Schema 325 Autonomic Innervation of Esophagus, Stomach, and Duodenum: Schema 326 Autonomic Reflex Pathways: Schema 327 Enteric Plexuses of Intestine 328 Autonomic Innervation of Liver: Schema 329 Autonomic Innervation of Pancreas: Schema

Kidneys and Suprarenal Glands  •  Plates 330–­343





330 Kidneys in Situ: Anterior Views 331 Kidneys in Situ: Posterior Views 332 Suprarenal Glands 333 Gross Structure of Kidney 334 Intrarenal Arteries and Renal Segments 335 Ureters in Abdomen and Pelvis 336 Arteries of Ureters and Urinary Bladder 337 Renal Fascia



338 Lymph Vessels and Lymph Nodes of Kidneys and Urinary Bladder 339 Autonomic Nerves of Kidneys, Ureters, and Urinary Bladder 340 Autonomic Innervation of Kidneys and Abdominal Part of Ureters: Schema 341 Autonomic Nerves of Suprarenal Glands: Dissection and Schema 342 Arteries and Veins of Suprarenal Glands in Situ 343 Abdominal Wall and Viscera: Paramedian Section

Lymphatics  •  Plates 344

344 Lymphatic Drainage of Abdomen and Pelvis: Schema

Regional Imaging  •  Plates 345–­346

345 Abdominal Scans: Axial CT Images 346 Abdominal Scans: Axial CT Images (Continued)

Cross-­Sectional Anatomy  •  Plates 347–­351

347 Cross Section at T10 Vertebral Level, Through Esophagogastric Junction 348 Cross Section at T12 Vertebral Level, Inferior to Xiphoid Process 349 Cross Section at T12/L1 Disc Level 350 Cross Section at L1/L2 Disc Level 351 Cross Section at L3/L4 Disc Level

Structures with High Clinical Significance  •  Tables 5.1–5.3 Muscles  •  Table 5.4 Electronic Bonus Plates  •  Plates BP 53–BP 83

BP 53 Inguinal and Femoral Regions BP 54 Indirect Inguinal Hernia BP 55 Variations in Position and Contour of Stomach in Relation to Body Habitus BP 56 Layers of Duodenal Wall BP 57 CT and MRCP Showing Appendix, Gallbladder, and Ducts; Nerve Branches of Hepatic Artery BP 58 Topography of Liver BP 59 Variations in Form of Liver BP 60 Sigmoid Colon: Variations in Position BP 61 Variations in Arterial Supply to Cecum and Posterior Peritoneal Attachment of Cecum BP 62 Variations in Pancreatic Duct BP 63 Variations in Cystic, Hepatic, and Pancreatic Ducts BP 64 Variations in Cystic Arteries BP 65 Variations in Hepatic Arteries



BP 66 Variations and Anomalies of Hepatic Portal Vein BP 67 Variations in Celiac Trunk BP 68 Variations in Colic Arteries BP 69 Variations in Colic Arteries (Continued) BP 70 Variations in Renal Artery and Vein BP 71 Histology of Renal Corpuscle BP 72 Nephron and Collecting Tubule: Schema BP 73 Blood Vessels in Parenchyma of Kidney: Schema BP 74 Lymph Vessels and Lymph Nodes of Stomach BP 75 Lymph Vessels and Lymph Nodes of Pancreas BP 76 Lymph Vessels and Lymph Nodes of Small Intestine BP 77 Lymph Vessels and Lymph Nodes of Large Intestine BP 78 Lymph Vessels and Lymph Nodes of Liver BP 79 Schematic Cross Section of Abdomen at T12 Vertebral Level BP 80 Transverse Section of Abdomen: L5 Vertebral Level, Near Transtubercular Plane BP 81 Transverse Section of Abdomen: S1 Vertebral Level, Anterior Superior Iliac Spine BP 82 Axial CT Image of Upper Abdomen BP 83 Arterial Variations and Collateral Supply of Liver and Gallbladder

SECTION 6 PELVIS  •  Plates 352–421 Surface Anatomy  •  Plate 352

352 Surface Anatomy of Pelvis

Bony Pelvis  •  Plates 353–357

353 Bony Framework of Pelvis 354 Male and Female Pelvis: Radiographs 355 Sex Differences of Bony Pelvis: Measurements 356 Ligaments of Bony Pelvis 357 Ligaments of Hip Bone

Pelvic Diaphragm and Viscera  •  Plates 358–­368

358 Pelvic Diaphragm: Female 359 Pelvic Diaphragm (Female): Medial and Superior Views 360 Pelvic Diaphragm (Female): Inferior Views 361 Pelvic Diaphragm (Male): Superior View 362 Pelvic Diaphragm (Male): Inferior View 363 Pelvic Cavity: Female 364 Pelvic Viscera and Perineum: Female 365 Female Internal Genital Organs 366 Endopelvic Fascia 367 Pelvic Cavity: Male 368 Pelvic Viscera and Perineum: Male

Urinary Bladder  •  Plates 369–­371

369 Urinary Bladder: Orientation and Supports 370 Female Urethral Sphincters 371 Urinary Bladder: Female and Male

Female Internal Genitalia  •  Plates 372–­376

372 Uterus, Vagina, and Supporting Structures 373 Uterus: Fascial Ligaments 374 Uterus and Adnexa 375 Pelvic Viscera: Female 376 Pelvic Ligaments

Female Perineum and External Genitalia  •  Plates 377–­380

377 Female Perineum and External Genitalia 378 Female Perineum (Superficial Dissection) 379 Female Perineum (Deeper Dissection) 380 Female Perineal Spaces

Male Perineum and External Genitalia  •  Plates 381–­388

381 Male Perineum and External Genitalia (Superficial Dissection) 382 Male Perineum and External Genitalia (Deeper Dissection) 383 Penis 384 Male Perineal Spaces 385 Prostate and Seminal Gland 386 Urethra 387 Descent of Testis 388 Scrotum and Contents

Homologies of Male and Female Genitalia  •  Plates 389–­390

389 Homologues of External Genitalia 390 Homologues of Internal Genitalia

Male Internal Genitalia  •  Plates 391–­392

391 Testes 392 Testis, Epididymis, and Ductus Deferens

Rectum  and Anal Canal  •  Plates 393–­399

393 Rectum in Situ: Female and Male 394 Ischioanal Fossae 395 Rectum and Anal Canal 396 Anorectal Musculature 397 External Anal Sphincter: Perineal Views 398 Perineal and Pelvic Extraperitoneal Spaces: Actual and Potential 399 Pelvic Scans: Sagittal T2-­Weighted MRIs

Vasculature  •  Plates 400–­410

400 Arteries of Rectum and Anal Canal: Male Posterior View 401 Veins of Rectum and Anal Canal: Female Anterior View 402 Arteries and Veins of Pelvic Viscera: Female Anterior View 403 Arteries and Veins of Testis: Anterior View 404 Arteries of Pelvis: Female 405 Arteries and Veins of Pelvis: Male 406 Arteries and Veins of Perineum and Uterus 407 Arteries and Veins of Perineum: Male 408 Lymph Vessels and Lymph Nodes of Pelvis and Genitalia: Female 409 Inguinal Nodes and Lymph Vessels of Perineum: Female 410 Lymph Vessels and Lymph Nodes of Pelvis and Genitalia: Male

Nerves of Perineum and Pelvic Viscera  •  Plates 411–­419

411 Nerves of External Genitalia: Male 412 Nerves of Pelvic Viscera: Male 413 Nerves of Perineum: Male 414 Nerves of Pelvic Viscera: Female 415 Nerves of Perineum and External Genitalia: Female 416 Neuropathways in Parturition 417 Innervation of Female Reproductive Organs: Schema 418 Innervation of Male Reproductive Organs: Schema 419 Innervation of Urinary Bladder and Lower Ureter: Schema

Cross-­Sectional Anatomy  •  Plates 420–­421

420 Male Pelvis: Cross Section of Bladder‒Prostate Junction 421 Female Pelvis: Cross Section of Vagina and Urethra

Structures with High Clinical Significance  •  Tables 6.1–6.3 Muscles  •  Table 6.4 Electronic Bonus Plates  •  Plates BP 84–BP 95

BP 84 BP 85 BP 86 BP 87 BP 88 BP 89 BP 90 BP 91 BP 92 BP 93 BP 94 BP 95

Fasciae of Pelvis and Perineum: Male and Female Cystourethrograms: Male and Female Female Urethra Genetics of Reproduction Menstrual Cycle Uterine Development Ovary, Oocytes, and Follicles Variations in Hymen Cross Section of Pelvis Through Prostate Arteries and Veins of Pelvis: Male (Featuring Prostate) Cross Section of Lower Pelvis Endocrine Glands, Hormones, and Puberty

SECTION 7

UPPER LIMB  •  Plates 422–­490

Surface Anatomy  •  Plates 422–­426

422 Surface Anatomy of Upper Limb 423 Cutaneous Innervation of Upper Limb 424 Superficial Veins of Proximal Upper Limb 425 Superficial Veins of Forearm and Hand 426 Lymph Vessels and Lymph Nodes of Upper Limb

Shoulder and Axilla  •  Plates 427–­439

427 Humerus and Scapula 428 Muscle Attachment Sites of Humerus, Scapula, and Clavicle 429 Clavicle and Sternoclavicular Joint 430 Shoulder: Anteroposterior Radiograph 431 Joints of Shoulder 432 Muscles of Shoulder 433 Axilla: Posterior Wall 434 Rotator Cuff Muscles 435 Pectoral, Clavipectoral, and Axillary Fasciae 436 Shoulder Region 437 Axillary Artery and Anastomoses Around Scapula 438 Axilla: Anterior View 439 Brachial Plexus: Schema

Arm  •  Plates 440–­445

440 Muscles of Arm: Anterior Compartment 441 Muscles of Arm: Posterior Compartment 442 Brachial Artery in Situ 443 Arteries of Upper Limb 444 Veins of Upper Limb 445 Arm: Serial Cross Sections

Elbow and Forearm  •  Plates 446–­461

446 Bones of Elbow 447 Elbow: Radiographs 448 Ligaments of Elbow 449 Bones of Forearm 450 Muscles of Forearm: Pronators and Supinator 451 Muscles of Forearm: Extensors of Wrist and Digits 452 Muscles of Forearm: Flexors of Wrist 453 Muscles of Forearm: Flexors of Digits 454 Muscles of Forearm: Superficial Part of Posterior Compartment 455 Muscles of Forearm: Deep Part of Posterior Compartment



456 Muscles of Forearm: Superficial Part of Anterior Compartment 457 Muscles of Forearm: Anterior Compartment 458 Muscles of Forearm: Deep Part of Anterior Compartment 459 Attachments of Muscles of Forearm: Anterior View 460 Attachments of Muscles of Forearm: Posterior View 461 Forearm: Serial Cross Sections

Wrist and Hand  •  Plates 462–­481

462 Carpal Bones 463 Movements of Wrist 464 Ligaments of Wrist: Anterior View 465 Ligaments of Wrist: Posterior View 466 Bones of Hand 467 Wrist and Hand: Radiographs 468 Metacarpophalangeal and Interphalangeal Ligaments 469 Wrist and Hand: Superficial Palmar Dissections 470 Wrist and Hand: Deeper Palmar Dissections 471 Lumbrical Muscles, Midpalmar and Thenar Spaces, and Tendon Sheaths 472 Flexor Tendons, Arteries, and Nerves at Wrist 473 Spaces and Tendon Sheaths of Hand 474 Flexor and Extensor Tendons in Fingers 475 Muscles of Hand 476 Arteries of Hand: Palmar Views 477 Wrist and Hand: Superficial Lateral Dissection 478 Wrist and Hand: Superficial Dorsal Dissection 479 Nerves and Arteries of Dorsal Hand and Wrist 480 Extensor Tendons at Wrist 481 Fingers

Nerves and Vasculature  •  Plates 482–­489

482 Cutaneous Innervation of Wrist and Hand 483 Arteries and Nerves of Upper Limb: Anterior View 484 Nerves of Upper Limb 485 Musculocutaneous Nerve 486 Median Nerve 487 Ulnar Nerve 488 Radial Nerve in Arm and Nerves of Posterior Shoulder 489 Radial Nerve in Forearm and Hand

Regional Imaging  •  Plate 490

490 Shoulder MRI and CT

Structures with High Clinical Significance  •  Tables 7.1–7.2

Nerves of Brachial Plexus  •  Tables 7.3–7.4 Muscles  •  Tables 7.5–7.8 Electronic Bonus Plates  •  Plates BP 96–BP 102

SECTION 8

BP 96 Arteries of Arm and Proximal Forearm BP 97 Arteries of Forearm and Hand BP 98 Ligaments of Wrist: Posterior and Anterior Views BP 99 Flexor and Extensor Zones of Hand BP 100 Cross Sections Through Metacarpal and Distal Carpal Bones BP 101 Cross Section of Hand: Axial View BP 102 Cross Section of Hand: Axial View (Continued)

LOWER LIMB  •  Plates 491–­556

Surface Anatomy  •  Plates 491–­494

491 Surface Anatomy of Lower Limb 492 Superficial Veins of Lower Limb: Anterior View 493 Superficial Veins of Lower Limb: Posterior View 494 Lymph Vessels and Lymph Nodes of Lower Limb

Hip, Buttock, and Thigh  •  Plates 495–­515

495 Hip Bone 496 Hip Joint 497 Hip Joint: Anteroposterior Radiograph 498 Attachments of Muscles of Hip and Thigh: Anterior View 499 Attachments of Muscles of Hip and Thigh: Posterior View 500 Femur 501 Muscles of Hip and Thigh: Lateral View 502 Muscles of Thigh: Anterior Compartment 503 Muscles of Thigh: Medial Compartment 504 Muscles of Hip and Thigh: Posterior Views 505 Psoas and Ilacus Muscle 506 Lumbosacral Plexuses 507 Lumbar Plexus 508 Sacral and Coccygeal Plexuses 509 Arteries of Thigh: Anterior Views 510 Arteries of Thigh: Anterior View of Deeper Dissection 511 Arteries of Thigh: Posterior View 512 Nerves of Buttock 513 Hip Bursae: Posterior and Anterolateral Views 514 Arteries of Femoral Head and Neck 515 Thigh: Serial Cross Sections

Knee  •  Plates 516–­523

516 Knee: Medial and Lateral Views 517 Knee: Anterior Views 518 Knee: Interior Views 519 Knee: Cruciate and Collateral Ligaments 520 Knee: Anteroposterior Radiograph and Posterior View 521 Knee: Posterior and Sagittal Views 522 Arteries of Lower Limb 523 Veins of Lower Limb

Leg  •  Plates 524–­534

524 Tibia and Fibula: Anterior and Posterior Views 525 Tibia and Fibula: Additional Views and Cross Section 526 Attachments of Muscles of Leg 527 Muscles of Leg: Superficial Part of Posterior Compartment 528 Muscles of Leg: Superficial Part of Posterior Compartment (Partial Dissection) 529 Muscles of Leg: Deep Part of Posterior Compartment 530 Muscles of Leg: Lateral Compartment 531 Muscles of Leg: Anterior Compartment 532 Muscles of Leg: Anterior Compartment (Continued) 533 Veins of Leg 534 Leg: Cross Sections and Compartments

Ankle and Foot  •  Plates 535–­549

535 Bones of Foot: Superior and Inferior Views 536 Bones of Foot: Lateral View 537 Calcaneus 538 Ligaments of Ankle and Foot 539 Ligaments of Foot: Plantar View 540 Tendon Sheaths of Ankle 541 Muscles of Dorsum of Foot: Superficial Dissection 542 Muscles of Dorsum of Foot: Deep Dissection 543 Sole of Foot: Superficial Dissection 544 Muscles of Sole of Foot: First Layer 545 Muscles of Sole of Foot: Second Layer 546 Muscles of Sole of Foot: Third Layer 547 Interosseous Muscles and Deep Arteries of Foot 548 Interosseous Muscles of Foot 549 Cross Section of Foot

Nerves  •  Plates 550–­554

550 Femoral Nerve and Lateral Femoral Cutaneous Nerve 551 Obturator Nerve 552 Sciatic Nerve and Posterior Femoral Cutaneous Nerve 553 Tibial Nerve 554 Common Fibular Nerve

Regional Imaging  •  Plates 555–­556

555 Hip: MRI and 3D CT 556 Ankle: Radiographs

Structures with High Clinical Significance  •  Tables 8.1–8.2 Nerves of Lumbosacral Plexus  •  Tables 8.3–8.4 Muscles  •  Tables 8.5–8.8 Electronic Bonus Plates  •  Plates BP 103–BP 112

BP 103 Arteries of Knee and Foot BP 104 Cross-­Sectional Anatomy of Hip: Axial View BP 105 Arteries of Thigh and Knee BP 106 Leg: Serial Cross Sections BP 107 Osteology of Knee BP 108 Knee Radiograph: Lateral View BP 109 Foot: Nerves and Arteries BP 110 Cross-­Sectional Anatomy of Ankle and Foot BP 111 Cross-­Sectional Anatomy of Foot BP 112 Anatomy of Toenail

References Index Available Online (see inside front cover) Bonus Plates Study Guides Self-Assessments

Appendixes e-­Appendix A: Plate Pearls e-­Appendix B: Study Guides

INTRODUCTION 1

General Anatomy Systematic Anatomy

1‒3 4‒21

Electronic Bonus Plates

BP 1‒BP 13

ELECTR O N I C B O N U S PL AT E S

BP 1 Pilosebaceous Apparatus

BP 2 Major Body Cavities

BP 3 Neurons and Synapses

BP 4 Features of a Typical Peripheral Nerve

BP 5 Sites of Visceral Referred Pain

BP 6 Sympathetic Nervous System: General Topography

BP 7 Parasympathetic Nervous System: General Topography

BP 8 Cholinergic and Adrenergic Synapses: Schema

1



INTRODUCTION

ELECT RO N I C B O N U S P L AT E S — c o n t’ d

BP 9 Architecture of Bone

BP 10 Muscle Structure

BP 11 Joints: Connective Tissues and Articular Cartilage

BP 12 Cardiovascular System: Composition of Blood

BP 13 Arterial Wall





Body Planes and Terms of Relationship Coronal plane

Superior

Transverse plane

Medial

Right

Lateral

Left Cranial Proximal

Proximal Posterior

Caudal

Sagittal plane Distal

Anterior

Distal Inferior

Plate 1 Body Planes and Terms of Relationship General Anatomy

Plate 1

1

Body Parts: Anterior View of Female

Forehead Head

Face

Eye Nose Cheek Mouth Chin

Neck Shoulder Axilla

Thorax

Upper limb

Breast

Arm Free part of upper limb

Elbow Forearm Abdomen

Wrist Hand

Perineum (a superficial part of the pelvis)

Hip

Lower limb Thigh Free part of lower limb

Knee

Leg

Ankle Foot

Plate 2 Body Parts: Anterior View of Female Plate 2

General Anatomy

Body Parts: Posterior View of Male

Head

Temple Occiput Ear Neck

Shoulder Axilla Upper limb Back Arm Elbow

Free part of upper limb

Forearm

Wrist Hand

Hip

Buttock

Thigh

Lower limb

Knee Free part of lower limb

Leg

Ankle Foot

Plate 3 Body Parts: Posterior View of Male General Anatomy

Plate 3

1

Overview of Nervous System Central nervous system

Peripheral nervous system

Brain

Cranial nn. Autonomic division Spinal nn.

Receptors

Spinal cord

Somatic sensory receptors: exteroceptors and proprioceptors

Special sense organs: somatic (eyeball and inner ear) and visceral (olfactory epithelium and taste buds)

Visceral sensory receptors: interoceptors

Sensory systems

Associative and integrative systems

Reflexes

Motor systems

Somatic nervous system

Autonomic nervous system

Parasympathetic division

Skeletal muscle

Sympathetic division

Smooth muscle Cardiac muscle Glands

Enteric nervous system

Smooth muscle Glands

Effectors

Plate 4 Overview of Nervous System Plate 4

Systematic Anatomy

1

Dermatomes of Upper and Lower Limbs See also Plate 188 Anterior view

Posterior view C2

C3 C3 C4

C4

C5

T2

C5

T2 C6

C6 C7 C7 T1 T1

T10 T11 T12 C8

T12 L1 L2 L3

L1

C6

C8

L2 L3

L3

L5 L4

S1 Anterior view

S2

L4

S1

Posterior view

Schematic based on Lee MW, McPhee RW, Stringer MD. An evidence-based approach to human dermatomes. Clin Anat. 2008;21(5):363–373. doi: 10.1002/ca.20636. PMID: 18470936. Please note that these areas are not absolute and vary from person to person. S3, S4, S5, and Co supply the perineum but are not shown for reasons of clarity. Of note, the dermatomes are larger than illustrated as the figure is based on best evidence; gaps represent areas in which the data are inconclusive.

Plate 5 Dermatomes of Upper and Lower Limbs Systematic Anatomy

Plate 5

Sympathetic Nervous System: Schema See also Plates 229, 249, 341, BP 6, BP 8, BP 52

Superior cervical ganglion Sympathetic trunk

Internal carotid n. Internal carotid plexus External carotid n.

First thoracic ganglion

External carotid plexus

Gray rami communicantes

Lacrimal gland Eye Parotid gland Skin (arrector pili mm., vascular smooth m., and sweat glands)

Sublingual gland

C1–C8

Submandibular gland Larynx Trachea Bronchi Lungs Cardiac nn. Greater thoracic splanchnic n. T1–T12

Heart

Celiac ganglion

Lesser thoracic splanchnic n. Stomach Aorticorenal ganglion Liver Gallbladder Bile ducts

White ramus communicans Gray ramus communicans

Pancreas

Least thoracic splanchnic n. Suprarenal gland Kidney Superior mesenteric ganglion Intestines Lumbar splanchnic nn.

L1–L5

First lumbar ganglion Superior hypogastric plexus

Sacral splanchnic nn.

Sigmoid colon

Inferior mesenteric ganglion

Rectum

S1

–S5

First sacral ganglion

Descending colon

Urinary bladder

Inferior hypogastric plexus

Prostate Preganglionic fibers Postganglionic fibers

External genitalia

Plate 6

Plate 6

Systematic Anatomy

Parasympathetic Nervous System: Schema See also Plates 324, 414, BP 7, BP 8

Ciliary ganglion Lacrimal gland

Oculomotor n. (CN III) Facial n. (CN VII)

Eye

Medulla oblongata Glossopharyngeal n. (CN IX)

Pterygopalatine ganglion

Mucous glands of nose, paranasal sinuses, and palate Parotid gland Sublingual gland

Otic ganglion Submandibular ganglion

Larynx

Submandibular gland

Trachea Bronchi Lungs

Vagus n. (CN X)

Celiac ganglion

Heart

Stomach Liver Superior mesenteric ganglion

Gallbladder Bile ducts Pancreas Suprarenal gland Kidney

Intestines Descending colon

Sigmoid colon S2

Rectum

S3 S4 Preganglionic fibers Postganglionic fibers

Pelvic splanchnic nn. External genitalia

Urinary bladder Prostate

Plate 7

Systematic Anatomy

Plate 7

1

Overview of Skeletal System See also Plate BP 9 Appendicular skeleton (126 bones)

Axial skeleton (80) Cranium (21) Neurocranium (8) Bones of midface (13)

Pectoral girdle (4)

Clavicle (2) Scapula (2)

Associated bones (8) Auditory ossicles (6) Mandible (1) Hyoid (1) Sternum (1) Ribs (24)

Skull and associated bones (29)

Thoracic skeleton (25)

Humerus (2) Radius (2) Ulna (2) Free part of upper limbs (60)

Carpal bones (16)

Vertebrae (24) Sacrum (1)

Vertebral column (26)

Coccyx (1)

Metacarpal bones (10) Phalanges of hand (28) Sesamoid bones

Pelvic girdle (2)

Hip bone (2) Femur (2) Patella (2)

Free part of lower limbs (60)

Tibia (2) Fibula (2) Tarsal bones (14) Metatarsal bones (10) Phalanges of foot (28) Sesamoid bones

Plate 8 Plate 8

Systematic Anatomy

Types of Synovial Joints See also Plate BP 11

Metaphysial bone tissue Subchondral bone tissue Articular cartilage Synovial membrane of joint capsule Fibrous layer of joint capsule Fibrocartilage Articular cartilage

Structure of synovial joints

Dens axis Humerus Atlas

Ulna

Axis

A. Hinge joint (e.g., elbow joint)

B. Pivot joint (e.g., median atlantoaxial joint) 1st metacarpal bone Femur

C. Saddle joint (e.g., metacarpocarpal joint of thumb)

Trapezium bone

Tibia D. Condyloid joint (e.g., knee joint)

Acetabulum Acromion

Clavicle

Head of femur E. Ball-and-socket joint (e.g., hip joint)

F. Plane joint (e.g., acromioclavicular joint)

Plate 9 Systematic Anatomy

Plate 9

1

Overview of Muscular System See also Plate BP 10

Facial expression

Neck

Pectoral Anterior arm Anterior abdominal wall Superficial back

Anterior forearm

Shoulder Hand Perineal

Posterior arm

Medial thigh Posterior forearm

Anterior thigh

Anterior leg

Lateral leg

Superficial gluteal

Posterior thigh

Foot

Posterior leg

Plate 10 Plate 10

Systematic Anatomy

Segmental Motor Nerve Function

Segmental innervation of upper limb movements C6–8 Pronation C7, 8 Extension C5, 6 Flexion

C5–7 Supination C7–T1 Flexion

C6–8 Extension

C7–T1 Abduction

C8–T1 Adduction

C7, 8 Extension

C7–T1 Flexion

Flexion

C7–T1 Extension

Extension

C8–T1 Flexion

C7–T1 Reposition

C8–T1 Opposition

Segmental innervation of lower limb movements

Lateral rotation L5–S1

Abduction L5–S1

Medial rotation L4–L5

Adduction L2–L4

Dorsiflexion L4, 5

L5, S1 Flexion

S1, 2 Eversion L5, S1

Inversion L4, 5

Plantar flexion

L5, S1

L2,

3

Flexion

L3, 4 Extension

Extension

Plate 11

Systematic Anatomy

Plate 11

1

Cross Section of Skin See also Plate BP 1

Free nerve endings

Tactile corpuscle (Meissner’s) Excretory pore of sweat gland

Hair shaft Melanocyte

Stratum lucidum

Arrector pili Sebaceous gland

Stratum granulosum

Cuticle

Stratum spinosum

Internal root sheath

Epidermis

Hair follicle

Stratum corneum

Stratum basale

External root sheath Glassy membrane

Papillary layer

Dermis

Fibrous sheath Sweat gland duct

Reticular layer

Hair cuticle Sweat gland

Subcutaneous tissue (hypodermis)

Lower germinal matrix of hair follicle Dermal papilla of hair follicle Lamellar corpuscle (Pacini’s) Artery Vein Sensory branches of cutaneous n. Elastic fibers

Subcutaneous a. and v.

Skin ligaments (retinacula cutis) Cutaneous n.

Plate 12

Plate 12

Systematic Anatomy

Overview of Cardiovascular System See also Plate BP 12

Volume distribution

Distribution of vascular resistance Small arteries and arterioles (47%) Brain

Lungs (9%) Veins (64%) Small arteries and arterioles (8%)

Veins (7%) Capillaries (27%)

Capillaries (5%) Heart in diastole (7%) Large arteries (7%)

Pulmonary vein

Lungs

Large arteries (19%)

Aorta Pulmonary artery Veins

Superior vena cava

LA Arteries

RA LV RV

Inferior vena cava

Heart

Liver Stomach

Hepatic vein Hepatic portal vein Low-pressure system (reservoir function)

Kidney

Venule

Muscle

High-pressure system (supply function)

Capillary

Arteriole

Skin and other organs

Plate 13

Systematic Anatomy

Plate 13

1

Major Arteries and Pulse Points See also Plate BP 13

Facial a. pulse point Carotid a. pulse point Right common carotid a.

Aortic arch

Left common carotid a.

Subclavian a.

Axillary a. Descending aorta Brachial a. pulse point Celiac trunk

Brachial a.

Renal a. Superior mesenteric a. Inferior mesenteric a.

Radial a.

Common iliac a.

Ulnar a. Ulnar a. pulse point

Internal iliac a.

Radial a. pulse point Deep palmar arch Superficial palmar arch

External iliac a. Deep femoral a.

Femoral a. pulse point

Femoral a. Popliteal a. pulse point

Popliteal a.

Anterior tibial a.

Locations for palpating arterial pulses (in bold)

Fibular a. Posterior tibial a. Posterior tibial a. pulse point

Dorsalis pedis a. pulse point

Dorsalis pedis a.

Plantar arch

Plate 14 Plate 14

Systematic Anatomy

Major Systemic Veins of Cardiovascular System

Major veins Superficial veins Deep veins External jugular v. Brachiocephalic v. Subclavian v.

Internal jugular v. Superior vena cava Azygos v.

Axillary v.

Intercostal vv.

Cephalic v.

Inferior vena cava

Brachial vv. Basilic v.

Renal v. Common iliac v.

Radial vv. Internal iliac v.

External iliac v. Superficial venous palmar arch

Deep femoral v.

Ulnar vv.

Femoral v. Palmar digital vv.

Great saphenous v.

Popliteal v.

Posterior tibial vv. Anterior tibial vv.

Dorsal venous arch

Plate 15 Systematic Anatomy

Plate 15

1

Overview of Lymph Vessels and Lymphoid Organs Lymphoid organs and tissues

Lymph vessels Lymph vessels of upper limb

Tonsils Lymph nodes of the neck Thymus

Thoracic duct

Axillary nodes Right lymphatic duct Mediastinal nodes Spleen Cubital nodes

Thoracic duct Lymph vessels of breast

Cisterna chyli

Lumbar nodes Aggregated lymphoid nodules of intestine (Peyer’s patches) Iliac nodes Inguinal nodes

Superficial Flow of Lymph

Red bone marrow

Popliteal nodes

Lymph vessels of lower limb

Drainage of thoracic duct Drainage of right lymphatic duct

Plate 16

Plate 16

Systematic Anatomy

Overview of Respiratory System

Pituitary gland

Falx cerebri Sphenoidal sinus

Pons

Supreme nasal concha Frontal sinus Superior nasal concha

Medulla oblongata

Nasal cavity Middle nasal concha

Nasopharynx Oropharynx Laryngopharynx Esophagus Cervical pleura Clavicle

Inferior nasal concha Nasal vestibule Pharyngeal opening of auditory tube Oral cavity Tongue Epiglottis Larynx Vocal fold (cord)

1st rib

Trachea

Costal part of pleura

Subclavian a. and v.

Mediastinal part of pleura

Aortic arch Left pulmonary a.

Right pulmonary a.

Left main bronchus

Right main bronchus

Descending aorta Sternum (cut away)

Right lung (covered by visceral pleura)

6th costal cartilage 7th costal cartilage

Hilum of right lung

Rectus abdominis m.

Mediastinal part of pleura Diaphragmatic part of pleura Diaphragm

Linea alba Internal abdominal oblique m. External abdominal oblique m. (cut away)

Plate 17

Systematic Anatomy

Plate 17

1

Overview of Digestive System

Pharynx Pharyngeal muscles propel food into esophagus

Liver Secretion of bile (important for lipid digestion); storage of nutrients; production of cellular fuels, plasma proteins, and clotting factors; detoxification and phagocytosis

Oral cavity, teeth, tongue Mechanical breakdown, mixing with saliva

Salivary glands (sublingual, submandibular, parotid) Secretion of lubricating fluid containing enzymes that initiate digestion

Pancreas Secretion of buffers and digestive enzymes by exocrine cells; secretion of hormones by endocrine cells to regulate digestion Esophagus Transport of food into the stomach

Gallbladder Concentration and storage of bile

Large intestine Dehydration and compaction of indigestible materials for elimination; resorption of water and electrolytes; host defense

Stomach Chemical breakdown of food by acid and enzymes; mechanical breakdown via muscular contractions; absorption of water, alcohol, and some minerals Small intestine Neutralization of acid from stomach; enzymatic digestion and absorption of water, organic substrates, vitamins, and ions; host defense

Plate 18 Plate 18

Systematic Anatomy

Overview of Urinary System

Suprarenal glands

Kidneys Ureters Suprarenal glands

Urinary bladder Urethra Kidneys Ureters

Urinary bladder Urethra

Plate 19

Systematic Anatomy

Plate 19

1

Overview of Reproductive System

Mammary glands (in breast)

Ductus deferens

Prostate

Seminal gland (vesicle)

Ovary Uterine tube

Penis

Uterus Epididymis Vagina Testis

Plate 20

Plate 20

Systematic Anatomy

Overview of Endocrine System

Pineal gland Melatonin Pituitary gland Anterior lobe: ACTH, TSH, GH, PRL, FSH, LH, and MSH Posterior lobe: Oxytocin and vasopressin (ADH)

Hypothalamus TRH, CRH, GHRH, GnRH, and somatostatin

Thyroid gland Thyroxine (T4), triiodothyronine (T3), calcitonin

Parathyroid glands Parathyroid hormone (PTH) Thymus Thymopoietin Heart Atrial natriuretic peptide (ANP) Digestive tract Enteroendocrine hormones: gastrin, secretin, CCK, GIP, motilin Suprarenal gland Medulla: epinephrine, norepinephrine Cortex: mineral corticoids glucocorticoids, androgens

Pancreatic islets (Langerhans) Insulin, glucagon, somatostatin Testis Androgens, inhibin

Kidney Erythropoietin (EPO), calcitriol, renin

Adipose tissue Leptin Ovaries Estrogens, progestins, inhibin, relaxin

Plate 21

Systematic Anatomy

Plate 21

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Pilosebaceous Apparatus

Epidermis

Hair shaft

Duct of sebaceous gland Sebaceous gland

Arrector pili Hair cortex

Hair medulla Hair cuticle Inner layer (Huxley’s) Internal root sheath Outer layer (Henle’s)

External root sheath

Dermal papilla of hair follicle Hair bulb

Plate BP 1 Pilosebaceous Apparatus Electronic Bonus Plates

Plate BP 1

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Major Body Cavities

Cranial cavity

Cranial cavity

Vertebral canal Superior mediastinum Pleural Thoracic cavity cavity Inferior mediastinum (including pericardial cavity)

Dorsal body cavity

Ventral body cavities

Diaphragm Vertebral canal

Abdominal cavity

Abdominopelvic cavity

Pelvic cavity

Plate BP 2 Major Body Cavities

Plate BP 2

Electronic Bonus Plates

Neurons and Synapses See also Plate BP 4

Endings of autonomic preganglionic fiber synapsing onto cell bodies of ganglionic neurons

Autonomic nerve endings on glandular epithelium, or smooth or cardiac muscle cells Satellite cells

Neurilemma surrounding unmyelinated axons of two neurons

Two postganglionic autonomic neurons of a sympathetic or parasympathetic ganglion

Dendrite Axon hillock Initial segment Node (Ranvier’s)

Axon

Myelin sheath

Dendrite

Schematic of synapses on neuron Numerous terminal boutons forming synapses on body and dendrites of a motor neuron

Neurofilaments Neurotubules Axon (axoplasm) Axolemma Mitochondria Glial process Synaptic vesicles Synaptic cleft Presynaptic membrane Postsynaptic membrane Postsynaptic cell

Enlarged section of bouton

Plate BP 3 Neurons and Synapses Electronic Bonus Plates

Plate BP 3

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Features of a Typical Peripheral Nerve See also Plate BP 3

Longitudinal vessels Outer epineurium Inner epineurium Fascicles

Nerve fibers

Fascicle Perineurium Nerve fibers

Cell body of an oligodendrocyte (Schwann cells play similar role in peripheral nervous system) Cell membrane of myelinated axon (axolemma) Mitochondrion in cytoplasm of axon

Node (Ranvier’s) Endoneurium

Minute masses of cytoplasm trapped between fused layers of cell membrane of oligodendrocyte

Fused layers of cell membrane of oligodendrocyte wrapped around axon of a myelinated neuron of central nervous system (the lipid of lipoprotein constituting fused cell membrane is myelin, which gives myelinated axon a white, glistening appearance)

Plate BP 4

Plate BP 4

Electronic Bonus Plates

Sites of Visceral Referred Pain

Diaphragm

Duodenum and head of pancreas

Stomach Spleen

Gallbladder Liver

Small intestine

Gallbladder Liver

Kidney and ureter

Cecum and ascending colon

Sigmoid colon

Plate BP 5

Electronic Bonus Plates

Plate BP 5

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Sympathetic Nervous System: General Topography Internal carotid plexus Internal carotid n. Superior cervical ganglion

Gray rami communicantes

External carotid n.

Sympathetic trunk Middle cervical ganglion

Cervical cardiac nn.

Cervicothoracic ganglion Thoracic visceral nn. Pulmonary plexus

Cardiac plexus

Gray ramus communicans White ramus communicans Esophageal plexus Greater thoracic splanchnic n.

Lesser thoracic splanchnic n.

Celiac plexus

Aorticorenal ganglion

Celiac ganglion

Lumbar splanchnic nn.

Superior mesenteric ganglion Superior mesenteric plexus

Inferior mesenteric ganglion Inferior mesenteric plexus Superior hypogastric plexus

Hypogastric n. Sacral splanchnic nn.

Inferior hypogastric plexus

Plate BP 6 Plate BP 6

Electronic Bonus Plates

Parasympathetic Nervous System: General Topography

Oculomotor n. (CN III) Facial n. (CN VII) Glossopharyngeal n. (CN IX) Vagus n. (CN X)

Lacrimal gland Ciliary ganglion Pterygopalatine ganglion Parotid gland Submandibular ganglion Sublingual gland Submandibular gland Cervical cardiac branch

Cardiac plexus Pulmonary plexus

Esophageal plexus Anterior vagal trunk

Posterior vagal trunk

Celiac plexus

Superior mesenteric plexus

Pelvic splanchnic nn. (from S2–4 spinal nn.) Inferior hypogastric plexus

Cavernous nn.

Plate BP 7 Electronic Bonus Plates

Plate BP 7

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Cholinergic and Adrenergic Synapses: Schema

Glossopharyngeal n. (CN IX) Medulla oblongata

Internal carotid n.

Parotid gland Larynx Trachea Bronchi Lungs

Vagus n. (CN X) Heart Cervical sympathetic ganglion

Striated m.

Sweat glands

Thoracic part of spinal cord

White ramus communicans

Gray ramus communicans

Celiac ganglion

Superior mesenteric ganglion Upper lumbar part of spinal cord

Arrector pili mm.

Peripheral aa.

Visceral aa. Gastrointestinal tract

Suprarenal gland

Inferior mesenteric ganglion Pelvic splanchnic nn. Urinary bladder

Sacral part of spinal cord C Cholinergic synapses A Adrenergic synapses

Sympathetic fibers

Presynaptic Postsynaptic

Parasympathetic fibers

Presynaptic Postsynaptic

Urethra Prostate

Somatic fibers Antidromic conduction

Plate BP 8

Plate BP 8

Electronic Bonus Plates

Architecture of Bone Osteoblasts (producing osteoid) Osteoid

Osteocytes Spongy bone

Medullary cavity (contains bone marrow: hematopoietic cells and adipose tissue)

Osteoclasts

Spongy bone

External circumferential lamellae

Internal circumferential lamellae Endosteum

Periosteum Compact bone

Concentric lamellae of osteon Osteonic canals (Haversian) Periosteal vessels

Compact bone

Plate BP 9 Electronic Bonus Plates

Plate BP 9

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Muscle Structure

Muscle

Nuclei (ghosted through endomysium) Myosatellite cell Basement membrane Sarcolemma Sarcoplasm

Muscle fiber

Tendon

Muscle fascicles

I

Perimysium Epimysium

Z

A H M

Myofibril

Z

Myofilaments

Sarcomere Z line

Z line

Sarcomere Z line

Z line I band

A band

I band

H band

A band

I band

H band

A band H band

I band

A band H band

Muscle relaxed

Muscle contracted

Plate BP 10

Plate BP 10

Electronic Bonus Plates

Joints: Connective Tissues and Articular Cartilage

Ground substance Fibroblast

Collagen fibers

Macrophage Elastic fibers Reticular fibers

Lymphocyte Monocyte

Capillary Red blood cell Endothelial cell Pericyte

Mast cell Adipocytes Macrophage

Section of loose connective tissue Eosinophil Articular cartilage Subchondral bone tissue

Plasma cell Longitudinal bundles of collagen and/or elastic fibers

Tendon sectioned longitudinally and transversely

Dense regular connective tissue Fibroblast nuclei Transverse

fibers of loose connective tissue

Articular cartilage Synovial membrane of joint capsule Fibrous layer of joint capsule

Architecture of articular cartilage and subchondral bone Joint with cartilage-covered articular surfaces

Plate BP 11

Electronic Bonus Plates

Plate BP 11

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Cardiovascular System: Composition of Blood

Plasma composition

Centrifuged blood sample

Water 92% Transports organic and inorganic molecules, cells, and platelets

Albumins 60% Transport lipids, steroid hormones; major contributors to osmotic concentration of plasma

Plasma proteins

7%

Other solutes

1%

Globulins 35% Transport ions, hormones, lipids; immune function Fibrinogen 4% Essential component of clotting system

Plasma ~55%

Buffy coat